AIDS denial: A lethal delusion

The effects of AIDS denialism in Africa are no joke, however. In 2000, as the movement was rapidly losing all credibility, South African president Thabo Mbeki asked some of the leading denialists to sit on an advisory council to guide his response to the epidemic. On their advice he did everything in his power to resist ART use in his country.

ON 27 December 2008, a well-heeled 52-year-old woman died in a Los Angeles hospital. Her death certificate describes a body riddled with opportunistic infections typical of the late stages of AIDS. Christine Maggiore had tested HIV positive 16 years earlier, but she had shunned ART, the antiretroviral therapy that stops HIV replicating and prevents AIDS.

This was not the first time a death in Maggiore’s family had made headlines: five years earlier her 3-year-old daughter Eliza Jane had died. The autopsy described a chronically ill little girl who was underweight, under-height, and had encephalitis and pneumonia – all AIDS-related. When pregnant, Maggiore had again rejected ART and she had breastfed Eliza Jane, another way of transmitting the virus.

Why, in 21st-century California, would a middle-class woman and her young daughter die like this when there is tried-and-tested treatment for their illness? The answer lies in a bizarre medical conspiracy theory that says AIDS is not caused by HIV infection (see Five myths about HIV and AIDS).

It is tempting to dismiss the so-called AIDS denialism movement out of hand, but it has a strong internet presence, with a plethora of websites and blogs that can mislead the unwary. While the movement has lately suffered some significant blows to its credibility, it has in the recent past wielded extraordinary influence, especially in southern Africa, the centre of the world’s AIDS epidemic. “Denialism has been relegated to the fringes of the internet, but it isn’t of no consequence,” says John Moore, an immunologist at Weill Cornell Medical College, Ithaca, New York, and one of the world’s foremost AIDS researchers. “It can still cost the lives of unsuspecting people.”